Individual provider Active NPI

Daniel A Gray, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1912651985
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10943 Issued in GA
Practice address
882 Ponce de Leon Ave NE
Atlanta, GA 30306-4268
Phone
(770) 809-3034
Fax
(404) 347-9445
NPI assigned
Feb 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 10943 GA Primary

Addresses

Primary practice location

882 Ponce de Leon Ave NE
Atlanta, GA 30306-4268

Mailing address

850 Piedmont Ave NE Unit 3118
Atlanta, GA 30308-1494
Phone (240) 409-1422

Other practice location 1

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4000

Other practice location 2

8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (470) 644-6000

Other practice location 3

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141-2068
Phone (470) 644-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220324002327 GA Practitioner - Physician Assistant 7911392162 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

2520 N Decatur Rd
Decatur, GA 30033-6117
Phone (678) 685-8100

3617 Roswell Nerd a
Atlanta, GA 30305-1111
Phone (404) 996-0196

572 Hank Aaron Dr
Suite 4200
Atlanta, GA 30312-2896
Phone (678) 535-0170

749 Lanier Ave W
Suite 1850
Fayetteville, GA 30214-7658
Phone (770) 835-4925

882 Ponce de Leon Ave
Atlanta, GA 30306-4268
Phone (770) 809-3034

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1912651985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 PIEDMONT AVE NE UNIT 3118",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303081494",
            "telephone_number": "240-409-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 PONCE DE LEON AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064268",
            "telephone_number": "770-809-3034",
            "fax_number": "404-347-9445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3950 Austell Rd",
            "address_purpose": "LOCATION",
            "city": "Austell",
            "state": "GA",
            "postal_code": "301061121",
            "country_code": "US",
            "telephone_number": "770-732-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8954 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301342272",
            "country_code": "US",
            "telephone_number": "470-644-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2518 Jimmy Lee Smith Pkwy",
            "address_purpose": "LOCATION",
            "city": "Hiram",
            "state": "GA",
            "postal_code": "301412068",
            "country_code": "US",
            "telephone_number": "470-644-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAY",
        "first_name": "DANIEL",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-09",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.